Individual
EBONY LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18679 LAKE HARBOR LN, PRAIRIEVILLE, LA 70769-5280
(225) 312-5730
(225) 312-5730
Mailing address
18679 LAKE HARBOR LN, PRAIRIEVILLE, LA 70769-5280
(225) 312-5730
(225) 312-5730
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/13/2026
Last updated
04/13/2026
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